University of Oslo, Norway, Institute of Health and Society, Pb 1130 Blindern, 0318, Oslo, Norway.
Norwegian University of Lifesciences. Faculty of Landscape and Society, Postbox 5003 NMBU, 1432, Ås, Norway.
Int J Obes (Lond). 2022 Jan;46(1):228-234. doi: 10.1038/s41366-021-00987-z. Epub 2021 Oct 14.
High body mass index (BMI) in childhood and adolescence is related to cardiovascular disease (CVD). Causality is not established because common genetic or early life socioeconomic factors (family factors) may explain this relationship. We aimed to study the role of family factors in the association between BMI and CVD by investigating if early adulthood BMI in conscripts and CVD mortality in their parents/aunts/uncles are related.
Data from the Armed Forces Personnel Database (including height and weight among conscripts) were linked with data from the Norwegian Population Registry, generational data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry using unique personal identification numbers. The study sample (N = 369,464) was Norwegian males born 1967-1993, who could be linked to both parents and at least one maternal and one paternal aunt or uncle. Subsamples were identified as conscripts whose parents/aunts/uncles had data on cardiovascular risk factors available from Norwegian health surveys. Cox proportional hazards regression models were used to estimate hazard ratios (HR) of CVD mortality in the parental generation according to BMI categories of conscripts.
Parents of conscripts with obesity or overweight had a higher hazard of CVD death (fathers HR obese: 1.99 (1.79, 2.21), overweight: 1.33 (1.24, 1.42) mothers HR obese: 1.65 (1.32, 2.07), overweight: 1.23 (1.07, 1.42)) than parents of normal- or underweight conscripts. Aunts and uncles of conscripts with obesity and overweight had an elevated hazard of CVD death, but less so than parents. Adjustment for CVD risk factors attenuated the results in parents, aunts and uncles.
Family factors may impact the relationship between early adulthood overweight and CVD in parents. These can be genes with impact on BMI over generations and genes with a pleiotropic effect on both obesity and CVD, as well as shared environment over generations.
儿童和青少年时期的高体重指数（BMI）与心血管疾病（CVD）有关。由于共同的遗传或早期社会经济因素（家庭因素）可能解释这种关系，因此因果关系尚未确定。我们旨在通过研究应征者的成年早期 BMI 与他们父母/姑/叔的 CVD 死亡率之间的关系，来研究家庭因素在 BMI 与 CVD 之间的关系中的作用。
利用独特的个人身份识别号码，将武装部队人员数据库（包括应征者的身高和体重）中的数据与挪威人口登记处、挪威基于家庭的生命历程研究的代际数据、国家教育登记处和死因登记处的数据进行链接。研究样本（N=369464）为 1967 年至 1993 年出生的挪威男性，他们可以与父母以及至少一位母亲和一位父亲的姑/叔联系起来。子样本被确定为应征者，其父母/姑/叔有来自挪威健康调查的心血管危险因素数据。使用 Cox 比例风险回归模型，根据应征者的 BMI 类别，估计父母一代 CVD 死亡率的危险比（HR）。
肥胖或超重应征者的父母患 CVD 死亡的风险较高（父亲肥胖的 HR：1.99（1.79，2.21），超重：1.33（1.24，1.42）母亲肥胖的 HR：1.65（1.32，2.07），超重：1.23（1.07，1.42））比正常或体重不足的应征者的父母高。肥胖和超重应征者的姑/叔患 CVD 死亡的风险也有所升高，但不如父母高。对 CVD 危险因素的调整削弱了父母、姑/叔的结果。
家庭因素可能会影响父母的成年早期超重与 CVD 之间的关系。这些因素可能是几代人之间影响 BMI 的基因，以及对肥胖和 CVD 都具有多效性的基因，以及几代人之间的共同环境。
